Sequential sports guard

ABSTRACT

The present invention provides protective repositioning appliances, accommodating mouth guards, and covering guards that protect an orthodontic patient against impact-induced injuries, as well as related systems and methods. A protective appliance can include teeth receiving cavities shaped to receive and reposition a patient&#39;s teeth and can include an occlusal portion having an impact-absorbing compliance. An accommodating mouth guard can include teeth receiving cavities shaped to accommodate a patient&#39;s teeth from a first arrangement to a second arrangement and can include an occlusal portion having an impact-absorbing compliance. A covering guard can include a guard segment that covers at least a portion of an appliance. The combination of a guard segment and an appliance can provide an occlusal compliance that absorbs impacts.

BACKGROUND

The present invention relates generally to the field of orthodontics,and more particularly to dental positioning appliances and mouth guardsthat provide protection against impact-induced injuries during a courseof orthodontic treatment, as well as related methods and systems.

An objective of orthodontics is to move a patient's teeth to positionswhere function and/or aesthetics are optimized. Traditionally,appliances such as braces are applied to a patient's teeth by a treatingpractitioner and the set of braces exerts continual force on the teethand gradually urges them toward their intended positions. Over time andwith a series of clinical visits and adjustments to the braces, thepractitioner adjusts the appliances to move the teeth toward their finaldestination.

More recently, alternatives to conventional orthodontic treatment withtraditional affixed appliances (e.g., braces) have become available. Forexample, systems including a series of preformed appliances/alignershave become commercially available from Align Technology, Inc., SantaClara, Calif., under the tradename Invisalign® System. The Invisalign®System is described in numerous patents and patent applications assignedto Align Technology, Inc. including, for example in U.S. Pat. Nos.6,450,807, and 5,975,893, as well as on the company's website, which isaccessible on the World Wide Web (see, e.g., the url“www.invisalign.com”). The Invisalign® System includes designing and/orfabricating multiple, and sometimes all, of the aligners to be worn bythe patient before the aligners are administered to the patient and usedto reposition the teeth (e.g., at the outset of treatment). Often,designing and planning a customized treatment for a patient makes use ofcomputer-based 3-dimensional planning/design tools, such as Treat™ fromAlign Technology, Inc. The design of the aligners can rely on computermodeling of a series of planned successive tooth arrangements, and theindividual aligners are designed to be worn over the teeth andelastically reposition the teeth to each of the planned tootharrangements.

While recently developed orthodontic treatment technologies, such asthose described above, represent a considerable advancement in the fieldof orthodontics, additional advancements remain of interest. Forexample, certain individuals may engage in a sporting activity duringtheir orthodontic treatment. In many sports, especially in contactsports such as football, a player typically wears a mouth guard so as toprotect the player against impact-induced injuries, includingconcussion. As such, there is a need for innovative products thatprovide an orthodontic patient with protection against impact-inducedinjuries.

BRIEF SUMMARY

The present disclosure provides protective positioning appliances,accommodating mouth guards, and covering guards that provide anorthodontic patient with protection against impact-induced injuries, andrelated systems and methods. The disclosed protective appliances,accommodating mouth guards, and covering guards provide the ability tohave a patient's teeth protected while undergoing orthodontic treatment,such with the Invisalign® System. Mouth guards are often used by playersof contact sports, such as football.

For a fuller understanding of the nature and advantages of the presentinvention, reference should be made to the ensuing detailed descriptionand accompanying drawings. Other aspects, objects and advantages of theinvention will be apparent from the drawings and detailed descriptionthat follows.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a jaw together with an incremental positioningappliance.

FIG. 2 illustrates a jaw together with a protective incrementalpositioning appliance according to an embodiment of the presentinvention.

FIG. 3 illustrates a jaw together with a protective incrementalpositioning appliance according to another embodiment of the presentinvention.

FIGS. 4A and 4B are cross-sectional illustrations of teeth receivedwithin protective incremental positioning appliances according toembodiments of the present invention.

FIG. 5 illustrates a fabrication process that can be used to createupper arch and lower arch protective incremental positioning appliances,accommodating mouth guards, covering guards, and/or accommodatingcovering guards that have complementary coupling features according toembodiments of the present invention.

FIGS. 6A and 6B are cross-sectional illustrations of teeth receivedwithin accommodating mouth guards according to embodiments of thepresent invention.

FIG. 7 is a cross-sectional diagram illustrating the accommodation of asingle tooth along a path of intermediate stages according toembodiments of the present invention.

FIGS. 8A and 8B are cross-sectional illustrations of teeth receivedwithin incremental positioning appliances that are coupled with coveringguards in accordance with embodiments of the present invention.

FIGS. 9A and 9B are cross-sectional illustrations of teeth receivedwithin incremental positioning appliances that are coupled withaccommodating covering guards in accordance with embodiments of thepresent invention.

FIG. 10 is a simplified block diagram illustrating a system ofaccommodating mouth guards in accordance with embodiments of the presentinvention.

FIG. 11 is a simplified block diagram illustrating a system ofaccommodating covering guards in accordance with embodiments of thepresent invention.

FIGS. 12 and 13 are simplified block diagrams illustrating methods forfabricating protective incremental positioning appliances according toembodiments of the present invention.

FIGS. 14 and 15 are simplified block diagrams illustrating methods forfabricating accommodating mouth guards according to embodiments of thepresent invention.

FIG. 16 diagrammatically illustrates a system according to an embodimentof the present invention.

DETAILED DESCRIPTION

Protective repositioning appliances, accommodating mouth guards,covering guards and accommodating covering guards are provided thatprotect an orthodontic patient against impact-induced injuries, as wellas related systems and methods. In the absence of adequate protection,players of certain contact sports, such as football, may be exposed to asignificant risk of impact-induced injuries. The presently disclosedappliances, guards, systems and methods provide a means by which anorthodontic patient can be protected against oral-related impact inducedinjuries during a course of orthodontic treatment.

A protective repositioning appliance can be configured to reposition apatient's teeth while protecting the patient against impact-inducedinjuries. Such a protective repositioning appliance can include teethreceiving cavities that are shaped to resiliently reposition a patient'steeth from a first arrangement towards a second arrangement. Aprotective repositioning appliance can be further configured to have ashape or material selected to provide protection against impact-inducedinjury.

An accommodating mouth guard can be configured to protect an orthodonticpatient's teeth during a portion of a course of orthodontic treatment,during which the patient's teeth are repositioned from a firstarrangement towards a second arrangement. An accommodating mouth guardcan include teeth receiving cavities that are shaped to accommodate arange of positions of the patient's teeth. A system of accommodatingmouth guards can be used to provide protection during multiple stages oforthodontic treatment, where during each stage a patient's teeth arerepositioned by some amount.

A covering guard can be configured to couple with at least a portion ofa tooth repositioning appliance. The combination of the covering guardand the tooth repositioning appliance can serve to protect theorthodontic patient against impact-induced injuries. An accommodatingcovering guard can be configured to couple with a sequence of toothrepositioning appliances.

Tooth Repositioning Appliances

FIG. 1 provides an appropriate starting point in a discussion of thepresent invention with respect to tooth repositioning appliancesdesigned to apply repositioning forces to teeth. A tooth repositioningappliance 10 can be worn by a patient in order to achieve an incrementalrepositioning of individual teeth in the jaw 11. The appliance caninclude a shell (e.g., polymeric shell) having teeth-receiving cavitiesthat receive and resiliently reposition the teeth. In one embodiment, apolymeric appliance can be formed from a known thin sheet of suitableelastomeric polymeric material, such a 0.03 inch thermal forming dentalmaterial by Tru-Tain Plastics, Rochester, Minn. An appliance can fitover all teeth present in an upper or lower jaw, or less than all of theteeth. In some cases, only certain teeth received by an appliance willbe repositioned by the appliance while other teeth can provide a base oranchor region for holding the appliance in place as it applies forceagainst the tooth or teeth targeted for repositioning. In some cases,many or most, and even all, of the teeth will be repositioned at somepoint during treatment. Teeth that are moved can also serve as a base oranchor for holding the appliance as it is worn by the patient.Typically, no wires or other means will be provided for holding anappliance in place over the teeth. In some cases, however, it may bedesirable or necessary to provide individual anchors on teeth withcorresponding receptacles or apertures in the appliance so that theappliance can apply a selected force on the tooth. Exemplary appliances,including those utilized in the Invisalign® System, are described innumerous patents and patent applications assigned to Align Technology,Inc. including, for example in U.S. Pat. Nos. 6,450,807, and 5,975,893,as well as on the company's website, which is accessible on the WorldWide Web (see, e.g., the url “www.invisalign.com”).

An appliance can be designed and/or provided as part of a set orplurality of appliances. In such an embodiment, each appliance may beconfigured so a tooth-receiving cavity has a geometry corresponding toan intermediate or final tooth arrangement intended for the appliance.The patient's teeth can be progressively repositioned from an initialtooth arrangement to a target tooth arrangement by placing a series ofincremental position adjustment appliances over the patient's teeth. Atarget tooth arrangement can be a planned final tooth arrangementselected for the patient's teeth at the end of all planned orthodontictreatment. Alternatively, a target arrangement can be one of manyintermediate arrangements for the patient's teeth during the course oforthodontic treatment, which may include where surgery is recommended,where inter-proximal reduction (IPR) is appropriate, where a progresscheck is scheduled, where anchor placement is best, where palatalexpansion is desirable, etc. As such, it is understood that a targettooth arrangement can be any planned resulting arrangement for thepatient's teeth that follows one or more incremental repositioningstages. Likewise, an initial tooth arrangement can be any initialarrangement for the patient's teeth that is followed by one or moreincremental repositioning stages. The adjustment appliances can begenerated all at the same stage or in sets or batches, e.g., at thebeginning of a stage of the treatment, and the patient wears eachappliance until the pressure of each appliance on the teeth can nolonger be felt or has resulted in the maximum amount of expressed toothmovement for that given stage. A plurality of different appliances(e.g., set) can be designed and even fabricated prior to the patientwearing any appliance of the plurality. After wearing an appliance foran appropriate period of time, the patient replaces the currentappliance with the next appliance in the series until no more appliancesremain. The appliances are generally not affixed to the teeth and thepatient may place and replace the appliances at any time during theprocedure (e.g., patient-removable appliances). The final appliance orseveral appliances in the series may have a geometry or geometriesselected to overcorrect the tooth arrangement, i.e., have a geometrywhich would (if fully achieved) move individual teeth beyond the tootharrangement which has been selected as the “final.” Such over-correctionmay be desirable in order to offset potential relapse after therepositioning method has been terminated, i.e., to permit movement ofindividual teeth back toward their pre-corrected positions.Over-correction may also be beneficial to speed the rate of correction,i.e., by having an appliance with a geometry that is positioned beyond adesired intermediate or final position, the individual teeth will beshifted toward the position at a greater rate. In such cases, the use ofan appliance can be terminated before the teeth reach the positionsdefined by the appliance.

Protective Repositioning Appliances

Protective dental appliances are provided that reposition a patient'steeth and provide protection against impact-induced injuries. Aprotective appliance can include teeth receiving cavities shaped toreceive and reposition a patient's teeth. A protective appliance canhave a shape or material selected to provide protection againstimpact-induced injury.

Referring now to FIG. 2, an embodiment of a protective repositioningappliance 20 is shown. Similar to the tooth repositioning appliance 10shown in FIG. 1, the protective repositioning appliance 20 includesteeth receiving cavities (hidden from view in FIG. 2) shaped to receiveand resiliently reposition a patient's teeth. In the embodiment shown,the protective appliance 20 includes an optional u-shaped tray 22 forreceiving the patient's opposite jaw teeth when the patient bites down.The u-shaped tray 22 can be defined in part by an occlusal-pad portion24, which can be configured so as to exhibit an impact-absorbingcompliance during an impact that forces the lower teeth into the upperteeth. The amount of compliance can be influenced by the elasticity andthickness of material used in the occlusal-pad portion. The amount ofcompliance can also be influenced by the span coverage of theocclusal-pad portion. Additionally, the optional u-shaped tray ispartially defined by buccal wall 26 and lingual wall 28. The buccal wall26 and lingual wall 28 can serve to laterally couple a plurality of apatient's upper and lower jaw teeth so as to help protect againstlateral impact-induced injuries by distributing localized lateralimpacts to surrounding tissues.

A protective repositioning appliance 20 can come in a range ofvariations. For example, an appliance 20 can also be adapted to permitbetter air flow and breathing while the patient bites down. In theembodiment shown, a plurality of traverse air passages 30 are providedso as to permit the flow of air between buccal and lingual sides of theappliance 20. A variety of other configurations can also be used tofacilitate mouth breathing. For example, one or more regions of thebuccal wall 26, the lingual wall 28, and/or the occusal-pad portion 24can be modified so as to provide air passages across the appliance 20. Aprotective repositioning appliance 20 can also include provisions forthe attachment of a connecting leash, such as the leash tab 32 shown. Aconnecting leash can be used to couple the appliance with the patient sothat it will not get misplaced, such as by attaching the connectingleash to a football helmet or the like. A variety of otherconfigurations may be used to provide for the attachment of a connectingleash, such as loops, sockets, or the like.

An appliance can also include a selected color or ornamental design. Forexample, an appliance can include embedded colors and/or logos, such asfor a team or a sponsor. As another example, an appliance can be madewith camouflage color for military use. An appliance can also be labeledwith personal information, such as the name of the owner, or the numberof the owner's athletic jersey.

An appliance can be multi-laminate in composition, such that thedifferent layers of the appliance confer different physical properties.For example, an outer layer can be softer for greater impact protectionand an inner layer can be made of harder material for better adaptationto the teeth. An appliance can be tri-laminate, with an outer layerbeing hard for durability, a middle layer being softer for impactabsorption, and an inner layer being hard for better adaptation andretention.

FIG. 3 illustrates another protective repositioning appliance 40, inaccordance with an embodiment. Appliance 40 includes a plurality ofteeth receiving cavities 42 for the patient's upper and lower teeth.Appliance 40 can be configured to be an integral unit, or can beconfigured to include an upper component 44 and a lower component 46,each of which can include teeth receiving cavities 42. Where separateupper and lower components are used, they can be configured withcomplementary interfacing surfaces (not shown in FIG. 3). Thesecomplementary interfacing surfaces can serve to laterally couple aplurality of a patient's upper and lower teeth, thereby helping todistribute localized lateral impacts to surrounding tissues. Thesecomplementary surfaces can also provide for snap-fit coupling betweenthe upper component 44 and the lower component 46. Appliance 40 can alsobe adapted to facilitate mouth breathing while the patient is bitingdown, such as by the traverse air passages 48 shown. Additionally, anappliance 40 can be adapted to facilitate mouth breathing in a varietyof different ways, such as discussed above with reference to FIG. 2.

FIGS. 4A and 4B are cross-sectional illustrations of embodiments ofprotective repositioning appliances. FIG. 4A illustrates a cross-sectionof an appliance 50 having lower-teeth receiving cavities. The appliancecan include an occlusal-pad portion 52 and an optional u-shaped tray 54for receiving the patient's upper teeth. As discussed above withreference to FIG. 2, the occlusal-pad portion 52 can be configured toexhibit an impact absorbing compliance so as to reduce peak forcestransmitted between the patient's jaws during an impact that forces thelower teeth into the upper teeth, or vice-versa. The optional u-shapedtray 54 can be configured to provide coupling between a plurality of thepatient's upper and lower teeth, so as to distribute localized lateralimpact forces to surrounding tissues thereby reducing the level oflocalized impact forces felt by local tissues. The appliance 50 of FIG.4A can be used to protect a patient against impact-induced injurieswhile simultaneously subjecting the patient's lower teeth to resilientrepositioning forces. An analogous, but opposite, appliance can be usedfor to reposition the patient's upper teeth while providing protectionagainst impact-induced injuries. The appliance 60 of FIG. 4B includes anupper component 62 having teeth receiving cavities for the patient'supper teeth 64, and a lower component 66 having teeth receiving cavitiesfor the patient's lower teeth 68.

The upper and lower components can be configured with complementaryshaped interfacing surfaces, such as the snap-fit surfaces 70 shown.These complementary-shaped surfaces can provide for lateral couplingbetween a plurality of the patient's upper and lower teeth, therebyenhancing the distribution of localized lateral impact forces tosurrounding tissues. Various complementary shaped interfacing surfacescan be used. For example, FIG. 5 illustrates a fabrication process thatcan be used to create upper arch and lower arch protective incrementalpositioning appliances, accommodating mouth guards, covering guards,and/or accommodating covering guards that have complementary couplingfeatures. Thin sheets 72, 74 of a suitable elastomeric polymericmaterial can be configured with complementary coupling features, such asribs on sheet 72 and grooves on sheet 74, or any other complementaryshaped features. Sheet 72 can be formed over a positive mold 76 to forman upper arch component 80 having complementary shaped features disposedon its outer surface. Likewise, sheet 74 can be formed over a positivemold 78 to form a lower arch component 82 having complementary shapedfeatures disposed on its outer surface. When worn by a patient, one ormore upper arch component features 84 can interface with one or morelower arch component features 86 so as to provide the above discussedlateral coupling. Components 80, 82 can be a protective incrementalpositioning appliance, an accommodating mouth guard, a covering guard,or an accommodating covering guard.

Accommodating Mouth Guards

Accommodating mouth guards are provided that can be used during aportion of a course of orthodontic treatment. An accommodating mouthguard can accommodate a range of positions of the patient's teeth. Anaccommodating mouth guard may or may not supply any repositioning forcesto a patient's teeth. Instead, an accommodating mouth guard can be usedin place of a tooth positioning appliance during a sporting activity.

Accommodating mouth guards are provided that can be used during a courseof orthodontic treatment. An accommodating mouth guard can include teethreceiving cavities shaped to accommodate a patient's teeth in a firstand a second arrangement. An accommodating mouth guard can have a shapeor material selected to provide protection against impact-inducedinjury.

FIGS. 6A and 6B are cross-sectional illustrations of embodiments ofaccommodating mouth guards. FIG. 6A illustrates a cross-section of anaccommodating mouth guard 100 having lower-teeth receiving cavities.Accommodation of a range of positions of the patient's teeth can beprovided in a number of ways. For example, as shown in FIG. 6A, theteeth receiving cavities can be configured with additional volumeselected to accommodate the range of positions. This additional volumeprovides a cavity of sufficient dimensions to accommodate a tooth in anyof the range of positions along the path of possible tooth positionsfrom the initial point to the end point (i.e., the tooth's sweptvolume). As another example, the appliance cavity walls can includesufficient compliance so as to be able to deflect a sufficient amount toaccept the tooth in any of the range of positions. A combination ofadditional volume and cavity wall compliance can also be used. As such,it is understood that a tooth receiving cavity can be shaped toaccommodate a range of positions for the tooth in a variety of ways,including those discussed above. Additionally, an accommodating mouthguard can include features similar to features of a protectiverepositioning appliance, such as the occlusal-pad portion 102 and theoptional u-shaped tray 104 as shown, and as discussed above withreference to FIG. 4A. Similarly, the accommodating mouth guard 100 ofFIG. 6A can be likewise configured for a patient's upper teeth.

Accommodating mouth guards can also be advantageously configured toselectively provide accommodation only for teeth that are beingrepositioned during a stage of orthodontic treatment. During orthodontictreatment using repositioning appliances, an appliance, or even a seriesof appliances, may be used to reposition a subset of the patient'steeth. The remaining teeth may not be repositioned during the stage oftreatment. The teeth receiving cavities for non-repositioned teeth canbe configured without accommodation, thereby providing for a more securecoupling with the non-moving teeth. This more secure coupling canprovide for a more secure coupling between the accommodating mouth guardand the patient's teeth in general.

The accommodating mouth guard 110 of FIG. 6B includes an upper component112 having teeth receiving cavities for the patient's upper teeth 114,and a lower component 116 having teeth receiving cavities for thepatient's lower teeth 118. As discussed above with reference to FIG. 6A,these teeth receiving cavities can be configured to accommodate a rangeof positions for any subset of teeth that are being repositioned duringa stage of orthodontic treatment, and omit accommodation for any subsetof teeth that are not being repositioned during the stage of treatment.Similarly, the upper and lower component can be configured withcomplementary-shaped interfacing surfaces, such as the snap-fit surfaces120 shown. These complementary-shaped surfaces can provide for a levelof lateral coupling between a plurality of the patient's upper and lowerteeth, thereby enhancing the distribution of localized lateral impactforces to surrounding tissues.

FIG. 7 is a simplified cross-sectional diagram of the cavity walls 121of an accommodating mouth guard and received teeth 122, 123, 124 thatillustrates the accommodation of a single tooth 123 along a path ofmovement. As can be seen, the cavity walls 121 that surround tooth 123are configured to accommodate the entire path of the tooth 123 (i.e.,the swept volume) for a sequence of positions 125, 126, 127. Suchaccommodation can also be incorporated into an accommodating coveringguard.

Accommodating mouth guards may also be designed to accommodateorthodontic treatment that is being performed using fixed wire andbracket braces. The accommodation in the mouth guard would allow themouth guard to fit around both the braces and the archwire, and enable arange of tooth movements to take place for the given time period forwhich the guard is applicable. The braces treatment plan can bedigitally planned out in advance, so that an accommodating mouth guardcan be designed to work for a specific portion of the treatment plan.

Covering Guards

Covering guards are provided that can be coupled with a toothrepositioning appliance so as to provide protection againstimpact-induced injuries. A covering guard can include a guard segmentthat covers at least a portion of an appliance. The combination of aguard segment and an appliance can have a shape or material selected toprovide protection against impact-induced injury.

Covering guards are provided that can be used in combination with arepositioning appliance so as to provide protection againstimpact-induced injury. FIG. 8A is a cross-sectional illustration of acovering guard 130 in accordance with an embodiment. As shown, acovering guard can be coupled with a basic repositioning appliance 132.A covering guard can be coupled with a repositioning appliance 132 in avariety of ways. For example, the covering guard 130 shown includesrepositioning appliance receiving cavities that provide an interfacewith the underlying repositioning appliance 132. A covering guard caninclude a variety of features similar to features discussed above, suchas an optional u-shaped tray 134 for receiving teeth from the opposingarch, and an occlusal-pad portion 136. As discussed above, the optionalu-shaped tray 134 can provide for lateral coupling between a pluralityof the patient's upper and lower teeth, thereby helping to distributelocalized lateral impact forces to surrounding tissues. The occlusal-padportion 136 can be configured to provide an impact-absorbing complianceso as to reduce peak forces transmitted between the patient's archesduring an impact that forces the arches together. This reduction of peaktransmitted forces can help to reduce the occurrence of impact-inducedinjuries, such as damage to teeth or concussion.

FIG. 8B is a cross-sectional illustration of a covering guard 140 inaccordance with an embodiment. The covering guard 140 includes an uppercomponent 146 adapted to couple with an upper-arch appliance 142, and alower component 148 adapted to couple with a lower-arch appliance 144.As discussed above, a variety of ways can be used to couple the upperand lower components with an underlying repositioning appliance. In theembodiment shown, the upper and lower components have appliancereceiving cavities that provide an interface with the underlyingrepositioning appliance. The upper and lower component can be configuredwith complementary-shaped interfacing surfaces, such as the snap-fitsurfaces 150 shown. Complementary-shaped interfacing surfaces canprovide for lateral coupling between a plurality of the patient's upperand lower teeth, thereby enhancing the distribution of localized lateralimpact forces to surrounding tissues.

Accommodating Covering Guards

Accommodating covering guards are provided that combine characteristicsof an accommodating mouth guard and a covering guard. As such, anaccommodating covering guard can be configured to interface with aseries of underlying repositioning appliances. FIGS. 9A and 9Billustrate embodiments of accommodating covering guards 160, 170.Because these accommodating guards share characteristics with theaccommodating mouth guards and covering guards discussed above, theabove discussion applies and will not be repeated here.

Protective Systems

Systems are provided that provide protection against impact-inducedinjuries during a multi-stage orthodontic treatment. An orthodontictreatment stage can include a series of appliances shaped to repositiona patient's teeth from an arrangement to a subsequent arrangement. Asystem can include a first accommodating mouth guard for use during afirst treatment stage, and a second accommodating mouth guard for useduring a second treatment stage. An accommodating mouth guard caninclude teeth receiving cavities shaped to accommodate a range ofpositions of a patient's teeth. An accommodating mouth guard can have ashape or material selected to provide protection against impact-inducedinjury. A system can include a first accommodating covering guard foruse during a first treatment stage, and a second accommodating coveringguard for use during a second treatment stage. An accommodating coveringguard can be configured to interface with a series of repositioningappliances.

A series of two or more of the above discussed protective repositioningappliances, accommodating mouth guards, covering guards, oraccommodating covering guards can be used for form a protective system.In the case of protective repositioning appliances or covering guards,the period of use of a particular protective repositioning appliance orcovering guard can be generally equivalent to the period of use of ananalogous or associated basic repositioning appliance. In the case ofaccommodating mouth guards or accommodating covering guards, the periodof use can be greater that the period of use of an analogous orassociated basic repositioning appliance. The period of use foraccommodating mouth guards or accommodating covering guards willtypically depend on the range of positions accounted for, and the ratethat the teeth are being repositioned.

FIG. 10 diagrammatically illustrates a system 180 of accommodating mouthguards. The system can include a first accommodating mouth guard 182that is worn during a first treatment stage during which the patient'steeth are repositioned from a first arrangement to a second arrangement.The system can include a second accommodating mouth guard 184 that isworn during a second treatment stage during which the patient's teethare repositioned from the second arrangement to a third arrangement. Thesystem can also include additional accommodating mouth guards, such asan Nth accommodating mouth guard 186. Similarly, FIG. 11diagrammatically illustrates an analogous system 190 of accommodatingcovering guards 192, 194, and 196.

Fabrication Methods

FIG. 12 diagrammatically illustrates a method 200 that can be used tofabricate of a protective positioning appliance. In step 202, digitalmodels of teeth-receiving cavities are obtained. These cavities areshaped so that when incorporated into a protective repositioningappliance the appliance exerts resilient forces to the patient's teethso as to reposition the patient's teeth over time. In step 204, thedigital models are used to fabricate a positive mold. The positive moldcan be fabricated using a variety of approaches, such as by way of arapid prototyping machine such as a stereo lithography or digital lightprojector machine, or also via computer numerical control (CNC) milling.An exemplary rapid prototyping machine is available from 3D System,Valencia, Calif. or EnvisionTEC, Gladbeck, Germany. The rapidprototyping machine can selectively harden a liquid or othernon-hardened resin into a three-dimensional structure which can beseparated from the remaining non-hardened resin, washed, and used as apositive mold for the appliance. Where such a fabrication method isused, a digital model that includes a negative representation of theteeth-receiving cavities can be prepared from which the positive moldcan be fabricated. In step 206, the appliance if fabricated by formingmaterial over the positive mold.

FIG. 13 diagrammatically illustrates a method 210 that can be used tofabricate of a protective positioning appliance having an uppercomponent with upper-teeth receiving cavities, and having a lowercomponent with lower-teeth receiving cavities. In step 212, digitalmodels of the teeth receiving cavities are received. In step 214, anupper-positive mold can be fabricated using the digital models for theupper-teeth receiving cavities as discussed above. In step 216, an uppercomponent is fabricated using the upper-positive mold. In step 218, alower-positive mold can be fabricated using the digital models for thelower-teeth receiving cavities as discussed above. In step 220, a lowercomponent is fabricated using the lower positive mold. In step 222, theappliance is fabricated using the upper and lower components.

FIG. 14 diagrammatically illustrates a method 230 that can be used tofabricate an accommodating mouth guard. In step 232, digital models ofteeth in an initial arrangement are obtained. In step 234, digitalmodels of teeth in a subsequent arrangement are obtained. The initialarrangement and the subsequent arrangements can be the starting and theending arrangements for which accommodation is to be provided. In step236, the digital models are combined so as to generate an accommodationmodel that includes geometry that accommodates the positions of theteeth as they move from the initial arrangement to the subsequentarrangement. Intermediate arrangements between the initial arrangementand the subsequent arrangement can also be used in the generation of theaccommodation model so as to more accurately accommodate forintermediate positions of the patient's teeth. A “swept volume”representing the spatial path of each tooth from the beginning to theend within the series can be built in so that the appliance will notinterfere with the tooth movement planned during the tooth movementinterval for which the guard is designed to accommodate. In step 238, apositive mold is fabricated by using the accommodation model. Thepositive mold can be fabricated in a variety of ways, such as by using arapid prototyping machine as discussed above. In step 240, theaccommodating mouth guard is fabricated using the positive mold.

FIG. 15 diagrammatically illustrates a method 250 that can be used tofabricate of an accommodating mouth guard having an upper component withupper-teeth receiving cavities and a lower component with lower-teethreceiving cavities. In step 252, digital models of teeth in an initialarrangement are obtained. In step 254, digital models of teeth in asubsequent arrangement are obtained. In step 256, the digital models areused to generate an accommodation model that includes geometry thataccommodates the positions of the teeth as they move from the initialarrangement to the subsequent arrangement. As discussed above, one ormore intermediate arrangements can also be used in the formation of theaccommodation model so as to more accurately account for intermediatepositions of the teeth. In step 258, a upper-positive mold is fabricatedby using the accommodation model. In step 260, an upper component isfabricated by using the upper-positive mold. In step 262, alower-positive mold is fabricated by using the accommodation model. Instep 264, a lower component is fabricated by using the lower-positivemold. In step 266, the mouth guard is fabricated from the upper andlower components.

FIG. 16 is a simplified block diagram of a data processing system 300embodying the present invention. Data processing system 300 typicallyincludes at least one processor 302 which communicates with a number ofperipheral devices via bus subsystem 304. These peripheral devicestypically include a storage subsystem 306 (memory subsystem 308 and filestorage subsystem 314), a set of user interface input and output devices318, and an interface to outside networks 316, including the publicswitched telephone network. This interface is shown schematically as“Modems and Network Interface” block 316, and is coupled tocorresponding interface devices in other data processing systems viacommunication network interface 324. Data processing system 300 could bea terminal or a low-end personal computer or a high-end personalcomputer, workstation or mainframe.

The user interface input devices typically include a keyboard and mayfurther include a pointing device and a scanner. The pointing device maybe an indirect pointing device such as a mouse, trackball, touchpad, orgraphics tablet, or a direct pointing device such as a touch screenincorporated into the display. Other types of user interface inputdevices, such as voice recognition systems, are also possible.

User interface output devices typically include a printer and a displaysubsystem, which includes a display controller and a display devicecoupled to the controller. The display device may be a cathode ray tube(CRT), a flat-panel device such as a liquid crystal display (LCD), or aprojection device. The display subsystem may also provide non-visualdisplay such as audio output.

Storage subsystem 306 maintains the basic programming and dataconstructs that provide the functionality of the present invention. Thesoftware modules discussed above are typically stored in storagesubsystem 306. Storage subsystem 306 typically comprises memorysubsystem 308 and file storage subsystem 314.

Memory subsystem 308 typically includes a number of memories including amain random access memory (RAM) 310 for storage of instructions and dataduring program execution and a read only memory (ROM) 312 in which fixedinstructions are stored. In the case of Macintosh-compatible personalcomputers the ROM would include portions of the operating system; in thecase of IBM-compatible personal computers, this would include the BIOS(basic input/output system).

File storage subsystem 314 provides persistent (non-volatile) storagefor program and data files, and typically includes at least one harddisk drive and at least one disk drive (with associated removablemedia). There may also be other devices such as a CD-ROM drive andoptical drives (all with their associated removable media).Additionally, the system may include drives of the type with removablemedia cartridges. The removable media cartridges may, for example behard disk cartridges, such as those marketed by Syquest and others, andflexible disk cartridges, such as those marketed by lomega. One or moreof the drives may be located at a remote location, such as in a serveron a local area network or at a site on the Internet's World Wide Web.

In this context, the term “bus subsystem” is used generically so as toinclude any mechanism for letting the various components and subsystemscommunicate with each other as intended. With the exception of the inputdevices and the display, the other components need not be at the samephysical location. Thus, for example, portions of the file storagesystem could be connected via various local-area or wide-area networkmedia, including telephone lines. Similarly, the input devices anddisplay need not be at the same location as the processor, although itis anticipated that the present invention will most often be implementedin the context of PCs and workstations.

Bus subsystem 304 is shown schematically as a single bus, but a typicalsystem has a number of buses such as a local bus and one or moreexpansion buses (e.g., ADB, SCSI, ISA, EISA, MCA, NuBus, or PCI), aswell as serial and parallel ports. Network connections are usuallyestablished through a device such as a network adapter on one of theseexpansion buses or a modem on a serial port. The client computer may bea desktop system or a portable system.

Scanner 320 is responsible for scanning casts of the patient's teethobtained either from the patient or from an orthodontist and providingthe scanned digital data set information to data processing system 300for further processing. In a distributed environment, scanner 320 may belocated at a remote location and communicate scanned digital data setinformation to data processing system 300 via network interface 324.

Fabrication machine 322 can encompass a range of fabrication machinesand methods used to fabricate positive molds, protective positioningappliances, accommodating mouth guards, or covering guards based on dataset information received from data processing system 300. In adistributed environment, fabrication machine 322 may be located at aremote location and receive data set information from data processingsystem 300 via network interface 324.

It is understood that the examples and embodiments described herein arefor illustrative purposes and that various modifications or changes inlight thereof will be suggested to persons skilled in the art and are tobe included within the spirit and purview of this application and thescope of the appended claims. Numerous different combinations arepossible, and such combinations are considered to be part of the presentinvention.

1. A removable dental appliance for repositioning a patient's teeth andproviding protection against impact-induced injuries, the appliancecomprising teeth receiving cavities shaped to receive and resilientlyreposition the teeth from a first arrangement toward a planned secondarrangement, the appliance having a shape or material selected toprovide protection against impact-induced injury.
 2. An appliance as inclaim 1, comprising an occlusal portion disposed between a plurality ofupper and lower teeth when the appliance is worn by the patient, theocclusal portion having a compliance selected to provide impactabsorption during an impact forcing the lower teeth into the upperteeth.
 3. An appliance as in claim 1, comprising a u-shaped portion forreceiving a plurality of teeth not received within said cavities.
 4. Anappliance as in claim 1, comprising a leash tab.
 5. An appliance as inclaim 1, adapted to facilitate mouth breathing while the patient bitesdown.
 6. An appliance as in claim 1, comprising a selected color orornamental design.
 7. An appliance as in claim 1, comprising amulti-laminate material.
 8. An appliance as in claim 1, comprising anupper component and a lower component, each of said componentscomprising teeth receiving cavities.
 9. An appliance as in claim 8,wherein the upper component and the lower component comprisecomplementary coupling features.
 10. An appliance as in claim 9, whereinthe complementary coupling features comprise snap-fit features.
 11. Anappliance as in claim 9, wherein the complementary coupling featurescomprise a plurality of ribs and a plurality of grooves.
 12. Anappliance as in claim 8, comprising an integral component comprising theupper component and the lower component.
 13. A mouth guard for useduring a portion of a course of orthodontic treatment, the mouth guardcomprising: a plurality of cavities for receiving a plurality of apatient's teeth during the portion of a course of orthodontic treatment,the cavities shaped to accommodate the received teeth when the teeth arein a first arrangement and when the teeth have been repositioned to asecond arrangement, the cavities further shaped to substantially matchor be enveloped by an accommodation envelope for the received teeth, theaccommodation envelope substantially matching a swept volume for thereceived teeth from the first arrangement to the second arrangement, themouth guard having a shape or material selected to provide protectionagainst impact-induced injury.
 14. An mouth guard as in claim 13,comprising an occlusal portion disposed between a plurality of upper andlower teeth when the mouth guard is worn by the patient, the occlusalportion having a compliance selected to provide impact absorption duringan impact forcing the lower teeth into the upper teeth.
 15. A mouthguard as in claim 13, wherein at least one of said plurality of cavitiesreceives a tooth that is not being repositioned during the portion of acourse of orthodontic treatment.
 16. A mouth guard as in claim 13,comprising a u-shaped portion for receiving a plurality of teeth notreceived within said cavities.
 17. A mouth guard as in claim 13,comprising a leash tab.
 18. A mouth guard as in claim 13, adapted tofacilitate mouth breathing while the patient bites down.
 19. A mouthguard as in claim 13, comprising a multi-laminate material.
 20. A mouthguard as in claim 13, comprising an upper component and a lowercomponent, each of said components comprising a plurality of saidcavities.
 21. A mouth guard as in claim 20, wherein the upper componentand the lower component comprise complementary coupling features.
 22. Amouth guard as in claim 21, wherein the complementary coupling featurescomprise snap-fit features.
 23. A mouth guard as in claim 21, whereinthe complementary coupling features comprise a plurality of ribs and aplurality of grooves.
 24. A mouth guard as in claim 20, comprising anintegral component comprising the upper component and the lowercomponent.
 25. A mouth guard as in claim 13, comprising a selected coloror ornamental design.
 26. A mouth guard as in claim 13, wherein aplurality of the received teeth have braces and the accommodationenvelope substantially matches a swept volume for the received teeth andbraces from the first arrangement and to the second arrangement.
 27. Acovering guard for providing protection against impact-induced injurieswhen coupled with a tooth repositioning appliance worn by a patient, thecovering guard comprising a guard segment configured to cover at least aportion of the tooth repositioning appliance, the combination of theguard segment and the appliance having a shape or material selected toprovide protection against impact-induced injury.
 28. A covering guardas in claim 27, the combination comprising an occlusal portion disposedbetween a plurality of upper and lower teeth when the combination isworn by the patient, the occlusal portion having a compliance selectedto provide impact absorption during an impact forcing the lower teethinto the upper teeth.
 29. A covering guard as in claim 27, comprisingthe tooth repositioning appliance.
 30. A covering guard as in claim 27,wherein the guard segment is adapted to interface with a sequence oftooth repositioning appliances.
 31. A covering guard as in claim 27,wherein the guard segment comprises a u-shaped portion for receiving aplurality of teeth not received within the tooth repositioningappliance.
 32. A covering guard as in claim 27, comprising a leash tab.33. A covering guard as in claim 27, adapted to facilitate mouthbreathing while the patient bites down.
 34. A covering guard as in claim27, comprising a multi-laminate material.
 35. A covering guard as inclaim 27, comprising at least one snap-fit feature for coupling theguard segment with the tooth repositioning appliance.
 36. A coveringguard as in claim 27, comprising a selected color or ornamental design.37. A covering guard as in claim 27, comprising an upper component forcovering an upper arch tooth repositioning appliance and a lowercomponent for covering a lower arch tooth repositioning appliance.
 38. Acovering guard as in claim 37, wherein the upper component and the lowercomponent comprise complementary coupling features.
 39. A covering guardas in claim 38, wherein the complementary coupling features comprisesnap-fit features.
 40. A covering guard as in claim 38, wherein thecomplementary coupling features comprise a plurality of ribs and aplurality of grooves.
 41. A covering guard as in claim 37, comprising anintegral component comprising the upper component and the lowercomponent.
 42. A system for providing protection against impact-inducedinjuries during orthodontic treatment comprising a first treatment stageand a second treatment stage, the first stage comprising a set ofappliances shaped to resiliently reposition a patient's teeth from afirst arrangement to a second arrangement, and the second stagecomprising a set of appliances shaped to resiliently reposition thepatient's teeth from the second arrangement to a third arrangement, thesystem comprising: a first mouth guard for use during the first stage,the first mouth guard comprising: a plurality of cavities for receivinga plurality of the patient's teeth, the cavities shaped to accommodatethe received teeth when the teeth are in the first arrangement and whenthe teeth have been repositioned to the second arrangement, the cavitiesfurther shaped to substantially match or be enveloped by a firstaccommodation profile for the received teeth, the first accommodationprofile substantially matching a swept volume for the received teethfrom the first arrangement to the second arrangement, the first mouthguard having a shape or material selected to provide protection againstimpact-induced injury; and a second mouth guard for use during thesecond stage, the second mouth guard comprising: a plurality of cavitiesfor receiving a plurality of the patient's teeth, the cavities shaped toaccommodate the received teeth when the teeth are in the secondarrangement and when the teeth have been repositioned to the thirdarrangement, the cavities further shaped to substantially match or beenveloped by a second accommodation profile for the received teeth, thesecond accommodation profile substantially matching a swept volume forthe received teeth from the second arrangement to the third arrangement,the second mouth guard having a shape or material selected to provideprotection against impact-induced injury.